title: Waist:height ratio: a superior index in estimating cardiovascular risks in Turkish adults.
abstract: OBJECTIVE
  To determine the best anthropometric measurement among waist: height ratio (WHtR), BMI, waist:hip ratio (WHR) and waist circumference (WC) associated with high CHD risk in adults and to define the optimal cut-off point for WHtR.
  
  
  METHODS
  Population-based cross-sectional study.
  
  
  METHODS
  Balcova, Izmir, Turkey.
  
  
  METHODS
  Individuals (n 10 878) who participated in the baseline survey of the Heart of Balcova Project. For each participant, 10-year coronary event risk (Framingham risk score) was calculated using data on age, sex, smoking status, blood pressure, serum lipids and diabetes status. Participants who had risk higher than 10 % were defined as 'medium or high risk'.
  
  
  RESULTS
  Among the participants, 67·7% were female, 38·2% were obese, 24·5% had high blood pressure, 9·2% had diabetes, 1·5% had undiagnosed diabetes (≥126 mg/dl), 22·0% had high total cholesterol and 45·9% had low HDL-cholesterol. According to Framingham risk score, 32·7% of them had a risk score higher than 10 %. Those who had medium or high risk had significantly higher mean BMI, WHtR, WHR and WC compared with those at low risk. According to receiver-operating characteristic curves, WHtR was the best and BMI was the worst indicator of CHD risk for both sexes. For both men and women, 0·55 was the optimal cut-off point for WHtR for CHD risk.
  
  
  CONCLUSIONS
  BMI should not be used alone for evaluating obesity when estimating cardiometabolic risks. WHtR was found to be a successful measurement for determining cardiovascular risks. A cut-off point of '0·5' can be used for categorizing WHtR in order to target people at high CHD risk for preventive actions.
authors.affiliation: 1Department of Nutrition and Dietetics,Izmir Ataturk School of Health,Ege University,Bornova,35100 Izmir,Turkey.
authors.forename: Reci
authors.initials: R
authors.lastname: Meseri
authors.affiliation: 2Faculty of Medicine,Department of Public Health,Dokuz Eylul University,Narlidere,Izmir,Turkey.
authors.forename: Reyhan
authors.initials: R
authors.lastname: Ucku
authors.affiliation: 2Faculty of Medicine,Department of Public Health,Dokuz Eylul University,Narlidere,Izmir,Turkey.
authors.forename: Belgin
authors.initials: B
authors.lastname: Unal
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000208:ethnology; D058065:Diabetic Cardiomyopathies / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D050177:Overweight / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D015995:Prevalence; D012306:Risk; D014421:Turkey / Q000453:epidemiology; D055105:Waist Circumference; D065927:Waist-Height Ratio